U.S. Preventive Services Task Force Recommends Voluntary HIV Testing for All Pregnant Women

The U.S. Preventive Services Task Force, an independent panel of U.S. health experts, has recommended that all pregnant women be offered an HIV test to further reduce mother-to-child transmission of the virus, according to a report in the July 5 issue of the Annals of Internal Medicine, Knight Ridder/Contra Costa Times reports. The task force's recommendations say that the current strategy of only offering tests to pregnant women deemed to be at "high risk" of being HIV-positive is missing opportunities to prevent vertical transmission. About 300 HIV-positive infants are born in the United States annually, and as many as 120 are born to women who did not know their HIV-positive status before delivery, according to Knight Ridder/Times. The task force recommended that the tests be voluntary for pregnant women (Krieger, Knight Ridder/Contra Costa Times, 7/5). The task force noted that recent scientific advances have proven that testing all pregnant women for HIV is beneficial. The panel's 1996 recommendation said there was insufficient evidence that testing all pregnant women had any benefit (Yates, AP/Seattle Times, 7/5). Providing combination drug therapies, offering caesarean-section delivery and advising HIV-positive women to avoid breastfeeding can reduce the risk of vertical HIV transmission from about 25% to about 1%. Although the task force, which is supported by the HHS Agency for Healthcare Research and Quality, issued its strongest recommendation regarding prenatal HIV tests, it also recommended that children and adults with one or more risk factors for HIV transmission be voluntarily tested for HIV (AHRQ release, 7/4). The risk factors include:

• Men who have had sex with men after 1975;
  
• Anyone having unprotected sex with multiple sex partners;
  
• Current or former injection drug users;
  
• People who exchange sex for money or drugs or have sexual partners who do;
  
• Individuals whose current or former sex partners are HIV-positive, bisexual or injection drug users;
  
• Men and women being treated for sexually transmitted diseases; and
  
• People who had a blood transfusion between 1978 and 1985.
  

The task force did not recommend HIV testing for children and adults who have none of the risk factors but advised testing patients at centers that have clients at high risk of the disease or that are located in areas with high HIV prevalence (Reuters Health, 7/5).

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